NPIMap

Individual provider Active NPI

Myles Antonioli, M.D.

  • Psychiatry Physician
  • Omaha, NE
National Provider Identifier
1609320050
Registry record updated Oct 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
TEP7824 Issued in NE
Practice address
985582 Nebraska Medical Ctr
Cu Department of Psychiatry
Omaha, NE 68198-5582
Phone
(402) 552-6222
NPI assigned
Aug 14, 2016
Last updated
Oct 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X TEP7824 NE Primary

Addresses

Primary practice location

985582 Nebraska Medical Ctr
Cu Department of Psychiatry
Omaha, NE 68198-5582

Mailing address

985582 Nebraska Medical Ctr
Cu Department of Psychiatry
Omaha, NE 68198-5582
Phone (402) 552-6222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mantonioli516022@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210608002120 UT Practitioner - Psychiatry 4688949928 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Oregon Health Sciences University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

501 S Chipeta Way
Salt Lake City, UT 84108-1222
Phone (801) 585-1575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.22 of 100Reported as group
Quality
83.74
Promoting interoperability
100
Improvement activities
40
Cost
66.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TEP7824NEMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Behavioral Health Services CurrentSince May 2, 2021 Accepting new patients
University of Utah Behavioral Health Services Psychiatry Current Accepting new patients
University of Utah Behavioral Health Services Psychiatry CurrentSince May 2, 2021 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

501 S Chipeta Way
Slc, UT 84108
Phone (801) 581-7951

240 Morris Ave
Ste 400
South Salt Lake, UT 84115
Phone (801) 581-5515

Interoperability endpoints

  • Direct secure messaging: mantonioli516022@direct.med.utah.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634342400000",
    "number": "1609320050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "985582 NEBRASKA MEDICAL CTR",
            "address_2": "CU DEPARTMENT OF PSYCHIATRY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985582",
            "telephone_number": "402-552-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "985582 NEBRASKA MEDICAL CTR",
            "address_2": "CU DEPARTMENT OF PSYCHIATRY",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681985582",
            "telephone_number": "402-552-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIOLI",
        "first_name": "MYLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-14",
        "last_updated": "2021-10-16",
        "certification_date": "2021-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NE",
            "license": "TEP7824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mantonioli516022@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.